Individual
RYAN KEITH ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5550 S EAST ST, SUITE I, INDIANAPOLIS, IN 46227-1979
(317) 780-4080
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02004819A
IN
207Q00000X
Family Medicine Physician
125.063436
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001013334
ANTHEM PTAN
IN
05
—
201361630
—
IN
Enumeration date
06/20/2013
Last updated
05/07/2025
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